Basic Information
| Provider Information | |||||||||
| NPI: | 1770817009 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VALLOT | ||||||||
| FirstName: | BRITT | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | ATC, LAT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2415 LAURA PL | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328033624 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5049522536 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3403 TECHNOLOGICAL AVE | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328171476 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4076812520 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/18/2009 | ||||||||
| LastUpdateDate: | 09/18/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2255A2300X | AL2746 | FL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer |
No ID Information.